Under The Knife: Sizemore's setback complicates Indians' future

Greetings from Toronto. I've hit the road in what has become an annual summer baseball tour. The next six days will have me trekking from my base in Indianapolis up to Toronto for a couple games, then down to Cleveland, Pittsburgh (the best park in baseball), and then to Cincinnati. While the travel is handled by my friends at Big League Tours, we'll be focusing on experiencing the parks and some great games (and hydration.) If you're along the way, drop me a line on Twitter and maybe we can meet up.

On the field, we're already starting to see some signs of issues with this crazy heat, so let's get right to the injuries:

Most of the early reports on Sizemore said his new knee problem was a repeat of the early-season bruising that necessitated a DL stint, mostly as a precaution. With Sizemore essentially the Patient Zero for microfracture in baseball, the Indians have to be more cautious. Later reports have been much more negative. It's his right knee again, which is not the knee on which he had surgery. The immediate worry is that Sizemore's unrepaired knee might have similar deterioration to the now-repaired left one, which would put him back where he was last year. That's an absolute worst case. It's still much more likely that this ends up like earlier this season, where he was out a bit longer than expected but came back fine. An MRI was encouraging, but it's clear that Sizemore does not yet have full confidence in his knees or in his ability to stay healthy. That's a major issue for the Indians since Sizemore has a club option for 2012. His talent, if healthy, is nearly impossible to replace, but for a team with a payroll just under $50 million, that $8 million decision is going to have a big impact, especially given a weak free agent class of OFs.

Halladay left his start early on Monday because of symptoms of heat illness, but is expected to make his next start. Halladay is just one of many, I'm sure, who will experience some level of heat illness as this "heat dome" creeps across the country. Heat illness is a very serious issue in sports, one I'll be tackling a lot this fall in relation to football, where it is too often a fatal issue for young football players. In baseball, a sport with ample opportunity for hydration, a limited population of players to monitor and no bulky clothing, it seems like the problem should be less, and it is, yet it's still a serious one. Cramping can lead to muscle strains. Fatigue can lead to various problems. While Halladay will be fine, and we hope the majority of those players who experience symptoms will end in need of only a short break, it's an issue that bears watching across baseball and across sports. Fans, too -- drink up, find some shade, and please don't forget the sunscreen.

Forget the three- or four-week estimates on Jones. He will start a short rehab assignment on Friday in Rome (A) and is expected back with the Braves on Sunday, his first day eligible. Yes, that means that he'll have come back from knee surgery in just two weeks, and yes, there are some concerns about that pace, especially with his history. Then again, Jones has passed every test the Braves' medical staff has thrown at him. The hope is that the knee cleanup will hold Jones together through the end of the season. I'm not more confident about that now than I was at the start of the season, but Jones is their best option at the position.

Heyward may be out for a couple days, maybe through the weekend, after taking a ball to the foot. It's a simple, but painful bruise. Once the symptoms are calmed down, he'll be able to get back out there, but we've seen that Heyward doesn't play well with pain, making it tougher for Fredi Gonzalez to push him back quickly.

The Brewers got Braun back in the starting lineup on Tuesday, but don't mistake that for healthy. They're easing him back in, playing him only five innings, which works well for a number of reasons. Braun will be spending a lot of time with the trainers, but the team thinks the risk of a setback is worth the gain they get with him in the lineup.

It's a tougher equation since Braun is so valuable; he's both a big positive when in and a big negative when out. I didn't run the numbers, but there likely are few positions with as big a swing in value between a starter and his replacement. Mark Kotsay may be a useful bench player, but he's not Braun. (Actually, the drop from Chase Utley to his replacements might be bigger, though the Phillies did well without him.) Braun's leg is a risk to fantasy players, especially over the next week to 10 days, when even a minor setback could have him back on the bench. You have to play him and hope, like the Brewers, for the best.

Morneau is doing more "baseball activities" and could begin swinging a bat later this week. He's just about a month post-surgery, after having a microdiscectomy to relieve pressure on the nerve that runs from the neck down to the shoulder. All signs so far are that the surgery was successful in relieving the issue, but since he hasn't started swinging a bat -- which was the big problem -- it's still not a known. Morneau will be about two weeks out once he starts swinging, assuming normal progress and a short rehab assignment. There are the possible setbacks, of course, and the Twins' tendency to like longer stays on rehab assignments, but Aug. 10 is a decent middle-ground ERD. The rehab from the surgery has also allowed his wrist to heal up, with the extra time off meaning he should see less of a power drop than normally expected after that injury. It's to a point where I'm going to pretend the wrist is fully healed, unless he shows some problems once he starts hitting.

No news is not always good news. Johnson has not been heard from since late June. He was supposed to be shut down for 10 days after Dr. James Andrews took a look and gave him a cortisone shot. It leaves him time for things like "Take Josh Johnson To School" (that's a real contest) but the Marlins would much rather see him throwing and on his way back to the rotation. There's no schedule for when that's going to happen, but even if the Marlins fall completely out of contention, the team will keep pushing Johnson back. Florida will want to see him throw if at all possible, both for evaluation and for a bit of confidence heading into their important 2012 campaign. Fantasy players won't see him before mid-August, if then, so you'll have to assess whether to drop him now or wait.

All anyone will notice is "95". That's what Davey Johnson hinted that Stephen Strasburg hit during a sim game on Monday. Johnson's old school enough to love the radar gun and ignore the biomechanics, but the reports were mostly positive from the first full-go work from Strasburg since Tommy John surgery 10 months ago. Strasburg appears to have everything back -- velocity, stuff, and his full repertoire of pitches -- but we don't have a good read on command or movement yet. We'll need hitters to tell us that, since I don't think PitchF/X was turned on when Strasburg was throwing. The Nats still don't have a solid timetable for his return, but there's an internal push for him to get at least three starts in September, including one that parts of the team's leadership would like to see involve Bryce Harper.

If you haven't seen Worrell pitch, go take a look. It's the craziest thing I've seen since -- well, who was that pitcher in Colorado who looked like his head was popping off with every pitch? Worrell's sidearm/screwball/sidestep delivery is a biomechanics nightmare, which is no surprise given that he had Tommy John in '09. So why do it? Steve Palazzolo, a minor league pitcher currently with Southern Maryland, summed it up well. "If it gets hitters out, you keep doing it. Hope to avoid injury. Injury-free mechanics might not get you there," he explained. Worrell's crazy delivery might distract bad hitters but he didn't see any of those on Monday night, when the Red Sox knocked him around. Quirky deliveries have their place in the game, but I hope kids around Maryland aren't trying to imitate Worrell in the back yard.

Bartolo Colon went 105 pitches last night and was solid. Ignore the loss; he pitched well enough to help his confidence ... Shaun Marcum plans to make his next start. He made his throw day, so that's a very good sign ... Placido Polanco is finally going to take the needle for his sore back. We'll see if he gets any relief from this ... Denard Span continues his rehab assignment in Rochester (AAA), but it's not going well from a baseball perspective. If there's any good news, it's that there has been no problems with post-concussion symptoms ... Jason Kubel is also in Rochester, where he's 1 for 8 for his two games there. The Twins want him to get 30 to 40 at-bats ... Brett Lawrie is back up at Las Vegas (AAA) and is reportedly wearing some sort of protective device on his hand/wrist. He was hit and said he felt fine afterwards. I've tried to find out what it is, but couldn't. I hope he continues, though MLB is very picky about what protective gear can be worn ... Scott Sizemore had to leave Tuesday's game when a bunt attempt made his old teammate Rick Porcello come up and in on him, leaving the pitch going off his collarbone instead of his bat ... Miguel Tejada went on the DL with a strained ab, which some think may have been a known quantity before the Jeff Keppinger deal.

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